The Year's Best Science Fiction 11

After the Neo-Hebbian, Bidwellian, and poetic-subjectivist viewpoints already expressed, it seems appropriate to investigate the clinician’s outlook. The following much-excerpted reprint is from a new magazine called Voices; the author, Jay Haley, has kindly given me permission to publish this drastically foreshortened version of a part of his article “The Art of Being Schizophrenic.”

... To use the term “schizophrenic” loosely for anyone who wanders in the hospital door looking befuddled betrays those individuals who have worked long and hard to achieve the disease.

People who have attempted schizophrenia without the correct family background have universally failed. . . . They can erupt into psychotic-like behavior in combat, or when caught in some other mad and difficult situation, but they are unable to sustain that behavior when the environment seems to right itself. The same point applies to the variety of fascinating drugs which are falsely said to induce psychosis. Not only does the drug influence miss the essence of the experience, but the effect wears rapidly off. The occasional goat who manages to be a schizophrenic after the drug has left his system is easily separated from the sheep who go back to normal—he has come from the right sort of family and probably would have achieved schizophrenia even without the benefit of medical research.

The Family: ... as individuals, the family members are unrecognizable on the street, but bring them together and the outstanding feature is immediately apparent—a kind of formless, bizarre despair overlaid with a veneer of glossy hope and good intentions concealing a power-struggle-to-the-death coated with a quality of continual confusion.

The Mother: Just as the child in a circus family learns from his parents how to maneuver on the slack wire, so does the schizophrenic learn from his mother how to maneuver acrobatically in interpersonal relations. To achieve schizophrenia a man must have experienced a mother who has a range of behavior unequaled except by the most accomplished of actresses. She is capable, when stung (which occurs whenever any suggestion is made to her), of weeping, promising violence, expressing condescending concern, threatening to go mad and fall apart, being kind and pious, and offering to flee the country if another word is said.

The Father: . . . must teach him to remain immovable. The father of the schizophrenic has a stubbornness unequaled among men (as well as the skill to keep a woman in the state of exasperated despair which helps mother make use of her full range of behavior). On occasions when present and sober such a father can easily say, “I am right, God in heaven knows I cannot be proven wrong, black is not white and you know it too in your heart of hearts.”

The Sibling (important, but not essential): . . . the kind of person who is hated on contact—a do-gooder, a good-in-schooler, a sweet, weak, kind bastard of a sibling.

The Budding Schizophrenic: . . . must hold a certain position in the family. . . . Like any artist, several hours a day of practice over many years are necessary.

It is the primary function of the schizophrenic to be the representative failure in the family. . . . The average schizophrenic shows his artistry by achieving more than usual ability along this line, while also indicating at regular intervals that he could do quite a good job at succeeding if he wanted to, thus giving [his parents] sufficient cause for disappointment.

The primary responsibility of the schizophrenic is to hold the family together. Although social scientists, even family therapists, have not yet the vaguest idea how to prevent a family from disintegrating, the schizophrenic child accomplishes this with ease. It is his duty to use his keen perception and interpersonal skill to maintain the family system in a stable state, even if that state is a mood of constant despair. His importance in this function appears on those rare occasions when the schizophrenic abandons his disease and becomes normal, succeeding in life and leaving his family. His parents at once individually collapse, losing their sense of purpose in life, and they set about to divorce.

[If, on The other hand, the family situation deteriorates, requiring heroic measures on the part of the schizophrenic...]

The Psychotic Episode: ... is merely a more extreme version of other behavior of the schizophrenic at times of family crisis, but this time it precipitates him into a situation which calls forth all his skill— the treatment situation.

Only in the mental hospital can schizophrenia achieve its full flowering. Just as a plant reaches its greatest growth in well-manured ground, so does the schizophrenic achieve his full range on the closed wards of mental institutions. Yet oddly enough the first reaction of the schizophrenic to hospitalization is a stout objection.

The Hospital: . . . the outstanding feature of a mental institution is a kind of formless, bizarre despair overlaid with a veneer of glossy hope and good intentions concealing a, power struggle to the death between patients and staff, coated with a quality of continual confusion. The basic art of schizophrenia lies in a genius for dealing with power struggles, and of course in a mental hospital the problem of power is central. It should not be thought that the struggle between patient and staff is unequal. True, the staff has drugs, tubs, cold packs, shock treatments (both insulin and electric), brain operations, isolation cells, control of food and all privileges, and the ability to form in gangs composed of aides, nurses, social workers, psychologists and psychiatrists. The schizophrenic Jacks all these appurtenances of power, including the use of gang tactics, since he is essentially a loner, but he has his manner and his words and a stout and determined heart.

(For those who would like to read more. Voices is a publication of the American Academy of Psychotherapists. Mr. Haley is director of the Family Experiment Project at the Palo Alto Mental Research Institute, and the author of several books, including Strategies of Psychotherapy.)